Distress level in newly diagnosed thyroid cancer patients and predictors of clinically significant distress

Although thyroid cancer has a favorable prognosis, patients experience significant psychological distress from the time of diagnosis. The study aimed to investigate the distress level in patients diagnosed or suspected of thyroid cancer, to characterize the major sources, and to determine the independent predictors of distress.

In this prospective study, patients who had presented to our institution between January 2024 and June 2025 were asked to complete the online questionnaires including the Distress Thermometer (DT) with problem list (PL). Group comparisons between the distress and non-distress groups were performed using Chi-square and t tests. Binary logistic regression analysis was used to identify independent factors associated with distress.

A total of 649 patients were included in analysis. 524 (80.74%) patients were classified in the distress group, while 125 (19.26%) were divided into the non-distress group. The mean DT scores were 7.21 ± 1.91 and 1.40 ± 1.24, respectively. The most frequently reported problems were worry (552, 85.05%), nervousness (498, 76.73%), sadness (433, 66.72%), treatment decisions (414, 63.79%), and fears (404, 62.25%). In multivariable analysis, male sex was independently associated with higher distress, whereas older age, higher education level, and stable employment were associated with lower odds of distress. Practical and emotional problems significantly predicted distress.

Clinically significant distress is highly prevalent at the time of thyroid cancer diagnosis. DT with PL is an efficient screening instrument and could be easily incorporated into practice. Early identification and support for vulnerable patients may help alleviate psychological burden and improve overall care.